Recommendations for 18 F-fluorodeoxyglucose positron emission tomography imaging for cardiac sarcoidosis: Japanese Socie
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Recommendations for 18F-fluorodeoxyglucose positron emission tomography imaging for cardiac sarcoidosis: Japanese Society of Nuclear Cardiology Recommendations Yoshio Ishida • Keiichiro Yoshinaga • Masao Miyagawa • Masao Moroi • Chisato Kondoh Keisuke Kiso • Shinichiro Kumita
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Received: 26 December 2013 / Accepted: 6 January 2014 Ó The Japanese Society of Nuclear Medicine 2014
Introduction Sarcoidosis is a systemic granulomatous disease that forms epithelioid cell granuloma (accompanied by infiltration of inflammatory cells) without caseous necrosis in organs throughout the body, including the lungs, lymph nodes, skin, eyes, heart, and muscles. Generally there is a good prognosis for spontaneous resolution of sarcoidosis; however, for cardiac-involvement sarcoidosis, the prognosis is extremely poor, and careful management is required. The most common cause of death from sarcoidosis is cardiac complications of the disease, and therefore early detection and treatment of these are very important in the management of cardiac-involvement sarcoidosis. Guidelines for the diagnosis of cardiac sarcoidosis were first published by Hiraga et al. [1] in 1992 (Table 1). These guidelines were modified by the joint committee of the
Committee for diagnosis of cardiac sarcoidosis using 18F-FDG PET, Japanese Society of Nuclear Cardiology.
Japan Society of Sarcoidosis and Other Granulomatous Disorders and the Japanese College of Cardiology in 2006 (Table 2) [2]. These modified guidelines stipulate the following: a histopathological or clinical diagnosis of sarcoidosis in organs other than the heart is essential, and the following cases should be diagnosed as cardiac sarcoidosis: (1) cases histopathologically diagnosed as positive for cardiac sarcoidosis on the basis of myocardial biopsy (histopathologically diagnosed group) and (2) cases with clinical findings indicating characteristic cardiac abnormalities including principal and secondary signs and symptoms (clinically diagnosed group) (Tables 1, 2). In the histopathologically diagnosed group, the positivity rate for detection of cardiac sarcoidosis may be low owing to sampling errors in myocardial biopsy. Hence, in actual clinical settings, the number of cases in the clinically diagnosed group is higher than in the histopathologically diagnosed group. Upon diagnosis of cardiac sarcoidosis, it is important to determine the disease activity to develop a treatment strategy, assess severity, predict prognosis, and
Y. Ishida Department of Cardiology, Kaizuka City Hospital, Kaizuka, Japan
C. Kondoh Department of Diagnostic Radiology, Tokyo Women’s Medical University, Tokyo, Japan
K. Yoshinaga (&) Department of Molecular Imaging, Hokkaido University Graduate School of Medicine, Kita15 Nishi7, Kita-Ku, Sapporo, Hokkaido 060-8638, Japan e-mail: [email protected]
K. Kiso Department of Radiology, National Cardiovascular Research Centre Hospital, Suita, Osaka, Japan
M. Miyagawa Department of Radiology, Ehime University Graduate School of Medicine, Matsuyama, Japan
S.
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